___________________________________ Code of Ethics for Counselors and Marriage and Family Therapists
arise, and a review of the most appropriate medium (e.g., video conference, text, email, etc.) or best options available for service delivery. f. It is incumbent on the therapist to engage in a continual assessment of the client’s appropriateness for teletherapy services throughout the duration of treatment. 9. Confidentiality of Communication a. Therapists utilizing teletherapy must meet or exceed applicable federal and state legal requirements of health information privacy, including HIPAA (https://www.hhs.gov/hipaa/for-professionals/ privacy/index.html) and HITECH (https://www. hhs.gov/hipaa/for-professionals/special-topics/ hitech-act-enforcement-interim-final-rule/index. html and https://www.hipaajournal.com/new-hipaa- regulations). b. Therapists must assess the remote environment in which services will be provided, to determine what impact there might be to the efficacy, privacy and/ or safety of the proposed intervention offered via teletherapy. c. Therapists must understand and inform their clients of the limits to confidentiality and risks to the pos- sible access or disclosure of confidential data and information that may occur during service delivery, including the risks of access to electronic commu- nications. 10. Professional Boundaries Regarding Virtual Presence a. Reasonable expectations about contact between ses- sions must be discussed and verified with the client at the start of treatment. The client and therapist must discuss whether the provider will be available for contact between sessions and the conditions under which such contact is appropriate. The therapist must provide a specific time frame for expected response to a between session contact. This must also include a discussion of emergency and crisis management between sessions. b. To facilitate the secure provision of information, therapists must provide in writing the appropriate ways to contact them. c. Therapists are discouraged from knowingly engaging in a personal virtual relationship with clients (e.g., through social and other media). Therapists must document any known virtual relationships with clients/associated with clients. d. Therapists must discuss, document, and establish professional boundaries with clients regarding the appropriate use and/or application of technology and the limitations of its use within the therapy relation- ship (e.g., lack of confidentiality, circumstances when not appropriate to use).
e. Therapists must be aware that personal information they disclose through electronic means may be broadly accessible in the public domain and may affect the therapeutic relationship. f. Virtual sexual interactions are prohibited. g. Therapists must be aware of statutes and regulations of relevant jurisdictions regarding sexual interactions with current or former clients or with known mem- bers of the client’s family system. 11. Impact of Social Media and Virtual Presence on Teletherapy a. Therapists must develop written procedures for the use of social media and other related digital technol- ogy with clients that provide appropriate protections against the disclosure of confidential information and identify that personal social media accounts are distinct from any used for professional purposes. b. Therapists separate professional and personal web pages and profiles for social media use to clearly dis- tinguish between the two kinds of virtual presence. c. Therapists who use social networking sites for both professional and personal purposes must review and educate themselves about the potential risks to privacy and confidentiality and consider utilizing all available privacy settings to reduce these risks. d. Therapists must respect the privacy of their clients’ presence on social media unless given consent to view such information. e. Therapists must avoid the use of public social media sources (e.g., tweets, blogs, etc.) to provide confiden- tial information. f. Therapists must refrain from referring to clients generally or specifically on social media. g. Therapists who engage in online blogging must be aware of the effect of a client’s knowledge of their blog information on the therapeutic relationship and place the client’s interests as paramount. 12. Documentation/Record Keeping a. All client-related electronic communications must be stored and filed in the client’s record, consistent with standard record-keeping policies and procedures. b. Written policies and procedures for teletherapy must be maintained at the same standard as in-person services for documentation, maintenance, and trans- mission of records. c. Services must be accurately documented as remote services and include dates, place of both therapist and client(s) location, duration, and type of service(s) provided. d. Requests for access to records require written authori- zation from the client with a clear indication of what types of data and which information is to be released.
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